WELCOME to Resource Information on Our Collaboration Councils, an Exciting & Unique Joint Labor-Management Partnership to Improve Quality Care and the Patient Experience Through Frontline Doctor Engagement with Hospital Administration Across the Health System and at Each Hospital and Facility, Benefiting Our Patients and the Communities We Serve

The leadership of Doctors Council SEIU and NYC Health + Hospitals jointly launched an historic and innovative partnership to improve the patient experience and quality of care in our public hospital system. On Friday, November 6, 2015 more than 100 leaders from the front-lines of care from both the Union and the management were present for the first meeting of the Collaboration Council. Read more…

NYC H+H frequently partners with the physician members of SEIU’s Doctors Council. Because of NYC H+H and the Doctors Council’s shared belief that “input [from] frontline clinicians into decision-making is essential” and that “[h]igh clinician engagement” and “professional satisfaction” improve patient care, the health care system and the doctors’ union agreed in 2015 to form Collaboration Councils to conduct quality-improvement projects and identify needed educational programs (NYC H+H & Doctors Council, Collaboration Councils Agreement). One recent Collaboration Council project focused on reducing patient wait times in radiology, thereby improving patient experience and worker morale. Union members gathered data about patient experience in the radiology department, and the department’s process for patient intake. The team’s first proposed changes did not achieve the desired results, so the team tried again with a new process and significantly improved the department’s wait-time scores on a patient-satisfaction survey.

Our cooperative projects, developed through a stable collective-bargaining relationship, depend on a collaborative culture between labor and management. These projects have produced significant, measurable benefits for patients.

Participation in the Collaboration Councils is open to all Doctors Council members who work in HHC facilities, whether as an HHC or affiliate (Mount Sinai School of Medicine, NYU or PAGNY) doctor, including Rikers.

WHY NOW?

HHC—the public health and hospital system in New York City, and the largest public hospital system in the nation—has to improve care, patient experience and capacity amidst the implementation of the Affordable Care Act and changing ways in how hospitals and health systems are reimbursed and funded, as well as measured and rated. Doctors’ morale is low. The number one resource that should be used to improve quality—the doctors’ understanding of the work we do—is not being leveraged to the maximum potential.

The challenges facing the system are more severe than ever before. We face obstacles in delivering the best care to our patients at a reasonable cost. Major challenges lie ahead for communities, health care professionals and safety–net institutions as to how they will proceed with the task of implementing and complying with new legislation and regulations in ways that not only increase access to care, but also improve healthcare outcomes. Coupled with intense budgetary pressures, more complex care, increasing chronic conditions, and demographic changes, the current landscape in healthcare is riddled with challenges that must be turned into opportunities for a transformative era of improvement. If we do not change, there is a good chance we will not be around in five, maybe ten years.

For too long, frontline doctors’ voices were not being heard and our efforts in bargaining over a period of years had been met with disinterest and a lack of respect. Our issues were not being addressed and this adversely impacted our ability to best serve the patients and communities we care for. Thus, our campaign was born to: RESET our relationship with HHC and the City’s partner Affiliates, REFOCUS on patient care, and REINSPIRE our practice by involving doctors in decisions that affect patient care. Ultimately, doctors sought to negotiate not only a strong contract, but a new standard for collaboration between doctors and hospital management.

Our Respect Campaign comprised of five key components, including community involvement,political action, a large rally attended by hundreds of doctors, other caregivers, patients, elected leaders, and community allies, member mobilization–including sending a petition to HHC President Ram Raju containing the signatures of over 1,000 doctors, and a paid media campaign that included subway, outdoor bus shelter, newspaper, digital, and radio advertisements. Additionally, we met with dozens of city council and citywide elected leaders to enlist their support, and met with community members and organizations around the city who recognized the important role that frontline doctors play in the health of New York’s diverse neighborhoods and communities. Ultimately, the success of our campaign rested on our ability to engage on all of these various fronts.

At the urging of our members, our Union successfully negotiated into our new collective bargaining agreement a unique and unprecedented opportunity for frontline clinicians to become active partners in the improvement of health care for our patients and our community. Now the process begins to make these Councils come alive and succeed.

If the HHC system is going to survive and thrive, it will need our direct involvement and a high level of engagement and buy-in to new systems of improvement for our patients. There will not be improved patient satisfaction without improved provider satisfaction!

Based on extensive surveys undertaken in the Fall of 2013 and into the Spring of 2014, 98% of our members believe that engaging in quality improvement process should be a priority for our Union. The surveys also told us that at least 50% of our colleagues stated that their experience with quality improvement projects had “not been rewarding at all.”

Based on these surveys, our Union wrote and widely circulated a White Paper which is a Call to Action for frontline clinician integration into a truly joint quality improvement strategy, to actualize the vision of our members’ demand for an equal voice in quality. Because of the strength of Doctors Council’s political action, we were able to present the findings of our surveys and our White Paper to the Deputy Mayor for Health and Human Services. Our political action was further instrumental in settling our contract which includes the attainment of the Collaboration Councils.

Now these efforts have resulted in formal agreements with HHC to take joint action on behalf of our patients, our communities, and ourselves.

There will be established a first ever System-wide Joint Steering Committee. It will be composed of one Doctors Council member representative from each of 21 facilities in the HHC system and top HHC management, including the Chief Medical Officer, Chief Operating Officer, the SVP of Affiliations, the Chief Quality Improvement Officer, and the Chief Financial Officer. The role of the Joint Steering Committee will be to oversee the successful implementation of facility-based high priority quality joint patient care improvement initiatives that are designed to attain strategic and sustainable improvements in the delivery of health care to our patients. The first meeting will occur on November 4, 5, and 6, 2015.

Three months after the System-Wide Joint Steering Committee has been meeting, there also will be established Facility-based joint committees at each of 21 facilities in HHC.* The facility based committees will be composed of one Doctors Council member from each department, as well as management representatives similar to those on the Steering Committee from the respective facility (COO, CMO, CFO, QIO). These committees will convene 90 days after the first Steering Committee meeting.

Doctors Council will be recruiting for both the System Wide Joint Steering Committee and the Facility-based committees concurrently so as to establish unity of involvement and purpose across the system.

Joint development of “demonstration projects” as learning laboratories

Creation of safe environments for learning and problem-solving

Development of educational programs to enhance knowledge and engagement of clinicians, paying close attention to the changing healthcare landscape, healthcare reform, business literacy, and quality measures

Through the implementation of these Collaboration Councils we begin a new era for Doctors Council SEIU. Our Union must transform as healthcare transforms…enabling our voices as leaders in quality improvement!